Format

Send to

Choose Destination
Eur J Health Econ. 2019 Mar 18. doi: 10.1007/s10198-019-01036-3. [Epub ahead of print]

Health state utilities associated with post-surgical Staphylococcus aureus infections.

Author information

1
Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD, 20814, USA. louis.matza@evidera.com.
2
Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD, 20814, USA.
3
Pfizer Inc, Collegeville, PA, USA.
4
Sydney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
5
Department of Orthopaedics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
6
Department of Orthopedic Surgery Sidney Kimmel Medical College, Thomas Jefferson University The Rothman Institute, Philadelphia, PA, USA.
7
Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
8
Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK.

Abstract

INTRODUCTION:

Surgical site infections (SSIs) are among the most common and potentially serious complications after surgery. Staphylococcus aureus is a virulent pathogen frequently identified as a cause of SSI. As vaccines and other infection control measures are developed to reduce SSI risk, cost-utility analyses (CUA) of these interventions are needed to inform resource allocation decisions. A recent systematic review found that available SSI utilities are of "questionable quality." Therefore, the purpose of this study was to estimate the disutility (i.e., utility decrease) associated with SSIs.

METHODS:

In time trade-off interviews, general population participants in the UK (London, Edinburgh) valued health states drafted based on literature and clinician interviews. Health states described either joint or spine surgery, with or without an SSI. The utility difference between otherwise identical health states with and without the SSI represented the disutility associated with the SSI.

RESULTS:

A total of 201 participants completed interviews (50.2% female; mean age = 46.2 years). Mean (SD) utilities of health states describing joint and spine surgery without infections were 0.79 (0.23) and 0.78 (0.23). Disutilities of SSIs ranged from - 0.03 to - 0.32, depending on severity of the infection and subsequent medical interventions. All differences between corresponding health with and without SSIs were statistically significant (all p < 0.001).

CONCLUSION:

The preference-based SSI disutilities derived in this study may be used to represent mild and serious SSIs in CUAs assessing and comparing the value of vaccinations that may reduce the risk of SSIs.

KEYWORDS:

SSI; Staphylococcus aureus; Surgery; Surgical site infection; Time trade-off; Utility

PMID:
30887157
DOI:
10.1007/s10198-019-01036-3

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center